Long-term care fraught with uncertainties for elderly baby boomers

GAINESVILLE, Fla. — The continued decline of the nursing home — once the mainstay care for the frail elderly — and an upsurge in popularity of assisted living will lead to many dramatic changes in long-term care, according to a University of Florida expert and editor of a new book on the subject.
“The American public has expressed a strong distaste for going to a nursing home because it smacks of a hospital-like, institutional way of living and receiving care,” said Stephen Golant, a UF geography professor and expert on elderly housing. “Assisted living has emerged as a highly attractive option for older persons who have experienced some physical or cognitive decline and feel less secure about receiving care in their own home.”
Yet there are few certainties about either the future of assisted living for the elderly or the huge number of baby boomers who stand to be its recipients, Golant said.
“Although baby boomers will constitute a large market, it is unclear what share will have impairments and chronic health problems that make them candidates for assisted living,” he said. “The emergence of an unexpected new medical or rehabilitation breakthrough, such as a cure or the discovery of a disease-controlling drug for Alzheimer’s disease – could result in a substantial decline in the number of elderly Americans who need such care.”

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

AAHSA’s Long-term Care Solution is in the News… Again

Since my last post, there have been even more AAHSA members getting letters to the editor published about AAHSA’s Long-term Care Solution as a way to alleviate the high costs of providing long-term care. Check these out:
  • Today, the Boston Globe published this letter from Elissa Sherman, executive director of MassAging, about an article regarding rising caregiving costs.
  • Jim Leich with the Indiana Association of Homes and Services for the Aging had this letter published in the July 6 edition of the South Bend Tribune.
Have you seen a similar story in your paper? Let us know and we can help you draft a letter of your own.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

AARP Solutions Forum Convenes Panel To Examine Medicaid Funding Of Long-Term Care

AARP will release a new report and convene a panel of experts to discuss Medicaid funding for long-term care (LTC) for older adults and adults with physical disabilities. The report analyzes the progress states are making shifting public funds and the people who rely on them from nursing homes to home and community based services.

Approximately 10 million older Americans need assistance with every day activities. Overwhelmingly, people (87 percent) prefer to receive this care in their homes or communities rather than in nursing homes. Few Americans have planned for the cost of LTC and by default Medicaid, which has an institutional bias towards nursing home care, is the primary payer.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

MEDSCAPE Search for Long Term Care

Examples (free access with registration):

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Long-Term Care Reform

If the materials are published after July 11, I'll link to them in LTC Reform blog

Event Summary

On July 11, the Brookings Institution’s Engelberg Center for Health Care Reform will host a Hill briefing on Long-Term Care Reform that will focus on opportunities to improve quality of care and address the long-term fiscal challenges of long-term care in the United States. The event will be co-hosted by The New School and the Center for Health Transformation.

Several distinguished panelists will participate in this special briefing, including Senator Ron Wyden, Senator Susan Collins, Representative Jim McCrery, Congressional Budget Office Director Peter Orszag, former Senator Bob Kerrey, former Speaker Newt Gingrich, and other expert panelists representing the policy, academic, advocacy and provider communities. Panelists will address policy options and political prospects for integrating long-term care reforms into broader health reform efforts to achieve improved care while also addressing issues of affordability and sustainability.

After each panel, participants will take audience questions.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Long-Term Care Financing Solutions: AARP

Earlier we blogged here about the long-term care financing forum at the University of Minnesota. One of the solutions put forward came from AARP. Here are highlights from Enid Kassner, director, Independent Living/Long-Term Care Public Policy Institute. Next we’ll share an approach from the American Association of Homes and Services for the Aging.

AARP’s Goal:

Create an affordable, consumer and caregiver-focused system providing coverage for, and access to, high quality long-term services and supports for independent living.

1. Promote - nationally and in the states - reform of delivery and financing for long-term services and supports.

2. REFOCUS reform debate on providing: long-term services and supports for independent living . . . rather than on “long-term care” or “Medicaid Reform.”

3. Include ALL populations, people with: developmental disabilities and physical disabilities . . . while improving services for seniors.

4. Defin “long-term services and support system” as FOUR separate, but related components:

1. Caregivers
2. Housing
3. Health Care
4. Long-Term and Community-Based Supportive Services

. . . . plus mechanisms to finance each component.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

MAPPING CARE OF OLDER PEOPLE

This analysis was sponsored by the Resolution Foundation and carried out by Deloitte & Touche LLP. It describes long-term care in England as a ‘mixed market’, made up of a combination of public and private funding and supply.

There is a widespread expectation that care provision is an integral part of the welfare state, but the reality is that long-term care is now almost entirely provided through private and third sector suppliers, and increasingly, is funded through private means.

The long-term care market does not function as a private market, because a series of intermediary processes such as means and needs testing that distort the interaction between supply and demand. These processes also have an impact on ‘self-funders’ who may face higher prices for similar services as a result of cross-subsidisation.

The analysis identifies key drivers of inefficiency and unfairness across the system, and tests the characteristics of supply, demand, and intermediary processes against indicators of a well-functioning market. This shows that whilst supplier profitability and entry and exit are stable, local markets and intermediary processes can distort outcomes for each individual, even for those who fund their care through private means.

The analysis indicates that the whole of the mixed market needs to be tackled, not just that part funded by the public sector. Innovation will be required by intermediaries, by the financial services sector, the supplier market as well as in the public sector.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Nursing homes, consumers lock horns over arbitration bill at congressional hearing

Providers cried "discrimination" and consumer advocates called for an even tougher stance Tuesday during a congressional hearing on the "Nursing Home Arbitration Act of 2008." House and Senate bills (H.R. 6126 and S. 2838) seek to disallow pre-admission clauses that bind residents to arbitration should a complaint be filed later.

Providers "aggressively oppose efforts to diminish the use of arbitration by American businesses, especially those unfairly targeting long-term care consumers and providers," testified Gavin Gadberry on behalf of the American Health Care Association and the National Center for Assisted Living before members of the House Judiciary Subcommittee on Commercial and Administrative Law. He said troubling anecdotes cited by others at the hearing were the exception rather than the rule in nursing homes.

Among those endorsing the "Fairness" act was AARP board member Dr. William Hall, who said he hoped to work with all parties to expand the bill's reach. AARP hopes that the bill would apply to "all current residents of long-term care facilities, not just those whose pre-dispute arbitration agreements are made, amended, altered, modified, renewed or extended on or after the date of enactment of the bill. The protections provided under this legislation should be available to all current long-term care facility residents."

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Divided we fail

The AARP is advocating a platform called Divided We Fail. This platform essentially seeks to remove health care and long-term financial security from being partisan issues, and make them the concern of all legislators and members of Congress.

The AARP had a vendor booth at our local Traverse City Senior Expo last week. They encouraged people to sign their pledge to support those running for office who support the Divided We Fail platform.


DIVIDED WE FAIL PLATFORM
We believe that the opportunity to have access to health care and long-term financial
security is a basic need that all Americans share. We believe it is the foundation for
future generations.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/

Older Adults More Likely To Go Into A Nursing Home Just After Death Of Spouse

The chances of older adults being institutionalized, for instance in a nursing home, go up significantly immediately after the death of a spouse, according to new research from Finland.

The study was conducted by Elina Nihtila and Pekka Martikainen, sociology researchers at the University of Helsinki in Finland and was published online in the American Journal of Public Health yesterday, May 29th.

The researchers investigated the risk of an older adult entering long-term institutional care after the death of their spouse, compared with how long they lived after their loss. They also looked at whether level of education or household income had an effect.

Norman DeLisle, MDRC
"With Liberty and Access for All!"
GrandCentral: 517-589-4081
MDRC Website: http://www.copower.org/
LTC Blog: http://ltcreform.blogspot.com/
Recovery: http://therecoveringlife.blogspot.com/
Change: http://prosynergypsc.blogspot.com/